title: Measurement of the coronary flow velocity reserve in patients with non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  Endothelial dysfunction is an early and reversible feature in the pathogenesis of atherosclerosis. Coronary flow velocity reserve is a noninvasive test showing endothelial function of epicardial coronary arteries and coronary microcirculatory function. This study was designed to evaluate the carotid intima-media thickness and myocardial microvascular circulation in patients with non-alcoholic fatty liver disease.
  
  
  METHODS
  Twenty-four patients with non-alcoholic fatty liver disease and 28 healthy subjects were studied. According to the pathology of liver biopsies, patients with non-alcoholic fatty liver disease were divided into non-alcoholic fatty liver and nonalcoholic steatohepatitis groups. Coronary diastolic peak flow velocities were measured at baseline, and then dipyridamole infusion was measured by transthoracic Doppler echocardiography. The ratio of hyperemic to baseline diastolic peak velocities was calculated and the intima-media thicknesss of the carotid arteries were measured.
  
  
  RESULTS
  Baseline average diastolic peak and diastolic mean flow velocities were similar between non-alcoholic fatty liver disease patients and healthy subjects. However, hyperemic average diastolic peak and diastolic mean flow velocities were significantly lower in the patient groups compared to those in the controls (p=0.005 and p=0.002). Coronary flow velocity reserve was 1.65 ± 0.36 and 2.67 ± 0.81 in patients and healthy subjects, respectively (p < 0.001). The intima-media thickness was similar between the patients with non-alcoholic fatty liver disease and healthy subjects. The comparison of patients with non-alcoholic fatty liver and non-alcoholic steatohepatitis within the non-alcoholic fatty liver disease group with respect to coronary flow velocity reserve and intima-media thickness yielded no statistical differences.
  
  
  CONCLUSIONS
  The present study showed that coronary flow velocity reserve, which establishes coronary microvascular and endothelial functions noninvasively, is significantly impaired in patients with non-alcoholic fatty liver disease. The impaired coronary flow velocity reserve-like early atherosclerotic changes may have value in the prediction of coronary artery disease in patients with non-alcoholic fatty liver disease.
authors.affiliation: İstanbul University İstanbul Medical Faculty, Department of Gastroenterohepatology, İstanbul, Turkey. binnurcapa@yahoo.com
authors.forename: Binnur
authors.initials: B
authors.lastname: Pinarbaşi
authors.forename: Kadir
authors.initials: K
authors.lastname: Demır
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Oflaz
authors.forename: Emel
authors.initials: E
authors.lastname: Ahishali
authors.forename: Filiz
authors.initials: F
authors.lastname: Akyüz
authors.forename: Ali
authors.initials: A
authors.lastname: Elıtok
authors.forename: Arif Oğuzhan
authors.initials: AO
authors.lastname: Çımen
authors.forename: Ebru
authors.initials: E
authors.lastname: Gölcük
authors.forename: Mine
authors.initials: M
authors.lastname: Güllüoğlu
authors.forename: Halim
authors.initials: H
authors.lastname: İşsever
authors.forename: Fatih
authors.initials: F
authors.lastname: Beşişik
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Kaymakoğlu
authors.forename: Atilla
authors.initials: A
authors.lastname: Ökten
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000502:physiology; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D004730:Endothelium, Vascular / Q000502:physiology; D005234:Fatty Liver / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease